Remember that old Bob Dylan song, "Don't think twice it's all
right"? That may be great advice in many situations, but when it comes to a
decision about whether or not to have a hysterectomy, it's best to think
twice and then twice again. The more informed a woman is about the pros and
cons of having her uterus, and possibly ovaries, removed, the better chance she
has of being happy with the outcome. The days of just going along with whatever
the gynecologist recommends are hopefully over. There are situations where a
hysterectomy is really the only way to save a woman's life, but these are rare.
It is up to each woman to seek the information, professional advice, care, and
support, and the inner wisdom to know what's right for her.

The startling facts about women and hysterectomies: l)
Approximately fifty percent of the women in the United States will undergo a
hysterectomy by age 70. 2) The average age for a hysterectomy in this country
is 35.6 years. 3) Hysterectomy is second only to caesarean section as the most
commonly performed major surgery in the United States - nearly one million each
year. 4) About 650,000 hysterectomies are performed each year. 5) The medical
term for removing the ovaries is "female castration". Approximately half a
million women experience this surgery each year in the United States. 6)
Ninety-eight percent of the women referred by HERS (Hysterectomy Educational
Resources and Services Foundation) to gynecologists for second opinions were
told they did not in fact need a hysterectomy. 7) The hospital cost alone for
hysterectomies alone in this country is approximately three billion dollars
annually.

When are hysterectomies recommended? Women who are diagnosedwith endometrial (uterine) cancer, ovarian cancer, or advanced stages of
cervical cancer generally need a hys-terectomy as a life-saving measure. Other
benign tumors, such as uterine fibroids or ovarian tumors, are occasionally so
large that the tumor alone cannot be removed.

In my experience, I have seen uterine fibroids to be the most common
reason for hysterectomies. Women often tell me, long after their surgeries,
that their mothers and grandmothers also had their uteruses removed for the
same reason. Some of these women have experienced fibroid-caused symptoms such
as excessive bleeding, urinary problems, pelvic pain, or painful intercourse.
Yet many women whose fibroids are diagnosed on a routine pelvic exam and who
are asymptomatic still end up with hysterectomies. There are natural alterna-
tives to surgery for uterine fibroids (see "Healing Uterine Fibroids" by my
husband and myself, The New Times , August, l990). And, in most cases,
even when surgery is necessary to take out the fibroid, it is usually possible
to leave the uterus and ovaries.

Hysterectomies are also recommended to some women who have excessive
bleeding during their perimenopausal period. Again, there are natural therapies
which usually control the bleeding (see my article "Womenopause", The New
Times, October, l990). These women are often told that they're not
going to need their uteruses anymore anyway, so "Why not take them out?". They
may also be urged to have their ovaries removed for the same reason. There are
other women who have endured excruciating menses since menarche and feel
relieved by the idea of ending their suffering early. A smaller number of women
receive hysterectomies for more unusual conditions such as recurrent ectopic
pregnancies or severe endometriosis.

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